Transforming the way patients get where they need to go
Claims Processing Specialist - Bilingual Spanish
Location
Texas
Posted
88 days ago
Salary
0
Seniority
Entry Level
Job Description
Claims Processing Specialist - Bilingual Spanish
SafeRide Health
Claims Processing Specialist - Bilingual (Spanish) Finance - San Antonio, Texas (Hybrid) SafeRide Health is looking for a hands-on Claims Specialist to scale SafeRide. We are looking for a leader with deep experience managing Medicare and Medicaid programs as we scale past $100M in annual revenue. The Billing Specialist is responsible for elevating SafeRide’s billing function and continuously enhancing the effectiveness of the organization. Strong business and financial orientation as well as a passion for growth and development are critical for this role. Responsibilities: - Facilitates data processing and processes claims for NEMT and GMR rides. - Performs reconciliation of billing data to encounter data. Works closely with the operations team to resolve issues. - Work with internal operations and project teams to solve claims-related problems, benefit plans research and provider contract interpretation and configurations. - Communicate and work with providers to get claims issues resolved and paid accurately and in accordance with healthcare/Medicare/Medicaid regulations, policies, and payment policies and guidelines. - Receive incoming calls from providers, customers, vendors, and internal groups, to successfully analyze the caller's needs, research information, answer questions, and resolved issues and/or disputes in a timely and accurate manner. - Identify issues negatively impacting the provider community including but not limited to system set up, required benefit modifications, EDI logic, provider education, claim examiner errors, and authorization rules. - Develops and implements policies, processes and procedures that incorporate industry best practices, and reinforces high quality standards within the Billing team. - Served as the Billing team’s subject matter expert and primary contact for claims related projects and critical activities. - Mentors junior team members and provides internal claims team training, coaching, guidance, and assistance with complex issues. - Implement: Scalable and accurate billing operations systems leveraging best in class technology. This includes financial reporting for management, clients and designated state and federal agencies (e.g., HHSC in Texas). - Champion and reinforce SafeRide’s culture. Required Education/Experience: - Minimum 1 years of experience in billing/claims management - Must be bilingual Spanish Speaking Preferred - NEMT/transportation background preferred - Knowledge of CMS/HHSC regulations preferred Skills - Strong data skills in Excel/Sheets, including pivot tables, v-lookups, etc. - Self-starter, ability to work independently and in a team environment. - Strength in problem solving, applying hard data and qualitative insight to frame problems and develop novel solutions - Ability to adapt to unforeseen circumstances quickly - Keen attention to detail - Ability to work with a variety of stakeholders What we offer you - An inclusive, encouraging and collaborative company culture - Strong support for career growth, including access to our investor communities - Competitive compensation with upside for growth (including stock options and performance grants) - Competitive benefits including health/vision/dental insurance, 401k match and 18 day’s PTO
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